Thursday, May 13, 2010

So as of today Cameron has had six sessions of the more aggressive method of positive reinforcement feeding. This is where they present him with a toy or tv and then take the toy or tv away and say "Time to take a bite." and hold the spoon to his lips while someone else holds him in place from behind so that he can't use his Ninja skills to swat at the spoon or thrash his head from side to side. He has the choice to keep his mouth shut or open it up and eat the food. If after a minute he still refuses they let him go and remove the spoon and change the mood to redirect his attention to something pleasant and then re-present the toy or tv show that is of most interest and try again. BUT if he does give in and open his mouth and swallow the food he gets the toy right away with lots of praise and the hands preventing him from escaping or swatting are instantly removed. This method allows us to provide him with an opportunity to make a choice without having his body instinctively react preventing him from ever getting a taste to learn if he likes and can deal with the food in his mouth. Basically it's stacking the deck in our favor so the only thing the child has to do is make a choice. Either way he gets praise and if he makes the right choice he gets a reward. Eventually he would associate eating with pleasure and reward and there would be no need to do anything but offer him the food to eat and he would eat it. Easy enough, right? ;-]

I asked the psychologist how do they know if this method is working and he said that the first sign is you should begin to see a decrease in the amount of time between when the spoon is presented and the mouth willingly opens. Then everything after that should follow through. If it didn't work the child would always refuse to open his mouth and he would continue to be upset about just one attempt of this for a long time afterward, even if ten minutes has passed since the attempt and you've moved him into a different room. The doctor felt that with my boys and in most kids you will typically see improvement after about 6 to 8 sessions of this method.

Last night at the dinner time feeding at home (he'd had his first three sessions of the Hands Down method during the day at feeding clinic) he was very upset, very frustrated, almost angry. He was flinging food and yelling and in general being far more uncooperative than usual, refusing pretty much all the food other than a few tastes but drinking a whopping 4oz of milk. Periodically he would say "Applesauce!" over and over, which was the food they had been feeding him at snack time where he'd fought them the hardest so I think that he was reminiscing about his day and telling me he remembered what happened.

Today I did not get to watch Cameron's breakfast because he was in a room without an observation window, but I was told later on that he ate four bites of yogurt without being held and even took a couple of those bites by handing back the toy and leaning forward with his mouth open! :-O

At lunch I missed out on watching a near perfect feeding session for Cameron because I was sitting in a parent chat session with some other parents of kids in the program. That was a really great chat we had and it was so nice just talking to other parents who have been where we have, who are struggling with the same issues we are, and who are at different stages in the program, one of whom is back for a second go around after a previous 9 week session that was tremendously successful and they are hoping to accomplish a bit more with this session.

During lunch Cameron only had to have his hands lightly touched and he willingly at every single one of his ten spoons full of mashed potatoes and gravy. :-D Again, on a couple of instances he even handed back his toy and leaned forward with an open mouth for his next bite!!!!!!!!!!

At snack time I think he was feeling a little cranky because he had to be held four times, but then began to willingly take the offered food and never lost the option to play with his toy. So it's okay now, you can go ahead and cry. I was sobbing. I am sobbing. It is working.

Evan is having a much more difficult time of it today, but I am keeping in mind that today was the very first time we've ever attempted this Hands Down Method that we are doing with Cameron. And Evan is definitely the more difficult one to convince, he's so stubborn and determined. And he has a much stronger gag reflex. My poor little Dragon.

But... BUT BUT BUT BUT.... At dinner tonight both boys ate! And I mean more than my sneaking in a spoonful while they are distracted. I simply presented an item they wanted just out of reach, said "Take a bite." and like a little bird Cameron opened up and ate six full baby spoonfuls of mixed veggie puree before eating four Gerber Lil' Crunchies Cheddar Cheese Puffs and then three spoons of butterscotch pudding. Evan was more difficult and he fought my holding his hands down (very difficult to do by one person who's also trying to get food into his mouth). But he did actually willingly eat four baby spoonfuls of the mixed veggie puree and two of the butterscotch pudding.

They are eating!! My boys are eating!! I can not wait to take them to feeding clinic tomorrow.

Cameron & Evan turn 0!

About Me

I'm a stay at home mom of surprise fraternal (we think) twin boys Cameron and Evan. They were born at 28 weeks 6 days due to Intra-uterine Growth Restriction (IUGR). We have struggled with global delays from prematurity, failure to thrive, feeding tubes, and re-learning to eat food by mouth. We're finally on the other side of the fence from our prematurity experience and I hope that something I write of our adventures in my online diary helps someone else struggling with similar experiences.